Increasing access to oral health care for people living with HIV/AIDS in rural Oregon.

Access to oral health care for people living with HIV/AIDS is a severe problem. This article describes the design and impact of an Innovations in Oral Health Care Initiative program, funded through the Health Resources and Services Administration HIV/AIDS Bureau's Special Projects of National Significance (SPNS) program, that expanded oral health-care services for these individuals in rural Oregon. From April 2007 to August 2010, 473 patients received dental care (exceeding the target goal of 410 patients) and 153 dental hygiene students were trained to deliver oral health care to HIV-positive patients. The proportion of patients receiving oral health care increased from 10% to 65%, while the no-show rate declined from 40% to 10%. Key implementation components were leveraging SPNS funding and services to create an integrated delivery system, collaborations that resulted in improved service delivery systems, using dental hygiene students to deliver oral health care, enhanced care coordination through the services of a dental case manager, and program capacity to adjust to unanticipated needs.

Community-based dental partnerships: improving access to dental care for persons living with HIV/AIDS.

Access to oral health care for persons living with HIV/AIDS is limited. Academic dental institutions can play a significant role in addressing the problem. The purpose of this article is to describe the design and impact of the Community-Based Dental Partnership Program (CBDPP), a federal program created to reduce dental care access disparities for persons living with HIV/AIDS through education and training of students and residents in underserved communities. CBDPP forms collaborations between participating dental education programs and community health organizations. Data for this report were drawn and analyzed from site visits, site visit reports, focus groups, and program data reports. In 2007, 4,745 individuals received oral health services through this program, an increase of 47 percent from 2004, the first year of full program operations. The number of dental providers who delivered oral health services grew from 766 in 2004 to 1,474 in 2007. Providers acquired skills, developed self-confidence, and overcame stereotypes in managing the oral health needs of persons living with HIV/AIDS. Community partners reported expanded dental care capacity to meet the unmet oral health needs of their service populations. CBDPP has had a positive impact on access to dental care and training of providers in HIV and oral health.

Using data to make decisions: planning HIV/AIDS care under the Ryan White CARE Act.

This article describes the challenges of using data to plan and fund HIV/AIDS care services for underserved populations under the Ryan White Comprehensive AIDS Resources Emergency (CARE) Act. It also outlines methods that have been developed by the Health Resources and Services Administration of the U.S. Department of Health and Human Services to assist community planning groups in using data to decide how to target limited federal resources under the CARE Act. Use of CARE Act dollars is guided largely by an array of legislatively identified priority areas, such as targeting of low income HIV-infected individuals who are not in care for their HIV disease. CARE Act program guidance covers the use of epidemiologic HIV and AIDS case data, quantification of unmet need for HIV care, guidance on making objective decisions on priorities for funding within a community planning process, and other instructions on the use of data in making decisions.